American Journal of Clinical Oncology最新文献

{"title":"Success of Ultra-low Dose Radiation Therapy for Primary Cutaneous B-cell Lymphoma.","authors":"Louisa Onyewadume, Shearwood McClelland","doi":"10.1097/COC.0000000000001113","DOIUrl":"https://doi.org/10.1097/COC.0000000000001113","url":null,"abstract":"OBJECTIVES\u0000Primary cutaneous B-cell lymphoma (PCBCL) is a relatively rare disease, associated with 5-year overall survival of nearly 95% when treated with external beam radiation therapy (EBRT) alone. However, standard EBRT doses yield acute skin toxicity in more than 70% of patients and grade 3 to 4 acute skin toxicity in nearly 10% of patients. Consequently, the PCBCL treatment paradigm is shifting towards lower EBRT doses. This study evaluates our early experience with ultra-low dose EBRT (total dose of 4 Gy in 2 fractions) for PCBCL.\u0000\u0000\u0000METHODS\u0000Four biopsy-confirmed PCBCL lesions (1 anterior thigh and 3 chest) in 2 male patients were treated with 2 Gy×2 fraction EBRT using electrons through a clinical setup. The anterior thigh lesion was treated using a clamshell to protect the scrotum from scatter dose. Treatment was achieved using 9 MeV electrons to the 85% isodose line using no bolus, with follow-up every 4 months and potential retreatment if no visible response at 8 to 9 months.\u0000\u0000\u0000RESULTS\u0000All lesions demonstrated a response to EBRT by 4 months, visibly manifesting as flattening with changes in pigmentation. At the last follow-up (20, 20, 16.5, and 4 mo, respectively), all lesions had flattened with no evidence of local recurrence and no skin toxicity.\u0000\u0000\u0000CONCLUSIONS\u0000Treatment of PCBCL with ultra-low dose EBRT to 4 Gy total dose in 2 fractions provides durable local control with zero skin toxicity. These results are encouraging for both the success of treatment and the potential to use similarly low doses for retreatment should patients exhibit local recurrence.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Educational Program to Standardize Education and Management of Immune-related Adverse Events: Review and Outcomes of a Single-institution Initiative.","authors":"M. Zibelman, Victoria Wong, Jennifer Reilly, Carolyn Zawislak, Darrin Richman, Cynthia Keleher, Brianna Herron, Christine Rafferty, Tracy Tisone, Barbara Rogers, R. Kokate","doi":"10.1097/COC.0000000000001112","DOIUrl":"https://doi.org/10.1097/COC.0000000000001112","url":null,"abstract":"BACKGROUND\u0000The use of immune checkpoint inhibitors (ICIs) as anticancer therapy across a variety of malignancies has led to durable efficacy in a subset of patients. However, associated side effects denoted immune-related adverse events (irAEs) have emerged and can result in substantial morbidity and mortality. Particularly early in the experience of using these agents, a lack of standardized education regarding irAEs among patients and clinical providers may have contributed to poor outcomes. Optimal management of these emerging toxicities depends on a coordinated institutional approach. We hypothesized that centralized educational programs and electronic health record (EHR)-based interventions, targeted both toward ICI-treated patients as well as patient-interfacing providers, would improve patient outcomes.\u0000\u0000\u0000METHODS\u0000We created a multidisciplinary team of clinicians and associated staff to direct a coordinated approach to the education and management of patients receiving ICIs across our institution. A 3-tiered approach was designed: patient-centered, internally centered, and externally centered. Multimedia educational products were produced for patients to improve knowledge and awareness of ICIs and associated irAEs. An EHR-based banner was deployed to improve identification of patients receiving ICIs across disciplines. Tailored educational seminars were provided to clinicians who interact with ICI-treated patients at all levels. Educational seminars were also offered to local physicians and institutions. We assessed patient uptake of educational products and surrogate patient outcomes to measure the potential impact of our interventions.\u0000\u0000\u0000RESULTS\u0000Fox Chase Cancer Center (FCCC)-specific ICI identification cards were created and distributed to patients. By the end of the investigational period, 98.6% of ICI-treated patients reported receiving a card. An ICI-focused on-line portal was created accessible only to ICI-treated patients, with 9.4% of these patients accessing the portal in the first 6 months without marketing promotion. Deidentified surrogate clinical endpoints of corticosteroid use, direct referral unit (DRU) visits, and hospital admissions all improved during the study period.\u0000\u0000\u0000CONCLUSIONS\u0000Institutionally directed educational initiatives are feasible at a free-standing academic cancer center and may lead to improved outcomes in patients developing irAEs from ICIs. More granular patient-specific data and studies at other types of institutions are necessary to determine the applicability of similar approaches on a broader scale.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The microRNA-34 Family and Its Functional Role in Lung Cancer.","authors":"Tinghua Zhang, Youyuan Hu, Na Yang, Shaofu Yu, Xingxiang Pu","doi":"10.1097/coc.0000000000001106","DOIUrl":"https://doi.org/10.1097/coc.0000000000001106","url":null,"abstract":"Lung cancer is one of the most common malignant tumors in humans and the leading cause of cancer-related deaths worldwide. The microRNA-34 (miR-34) family is dysregulated in various human cancers and is an important family of tumor suppressor genes among microRNAs. The miR-34 family is downregulated in lung cancer. It inhibits cell proliferation, metastasis, and invasion, arrests the cell cycle, and induces apoptosis or senescence by negatively regulating many oncogenes. It is commonly used to detect and treat lung cancer. This study describes the regulatory role of the miR-34 family in lung cancer and the associated research advances in treatment.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140827002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Endometrial Cancer Clinical Trial Representation: Exploring the Role of Eligibility Criteria.","authors":"Jennifer L Wolf, Alexandra Hamilton, Anjile An, John P Leonard, Margaux J Kanis","doi":"10.1097/coc.0000000000001107","DOIUrl":"https://doi.org/10.1097/coc.0000000000001107","url":null,"abstract":"This study aimed to determine whether Black patients with recurrent endometrial cancer were more likely than White patients to be ineligible for a recently published clinical trial due to specific eligibility criteria.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140827018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Online Model for Central Lymph Node Metastases in Papillary Thyroid Carcinoma With BRAF V600E Mutation.","authors":"Hao Chen, Wen-Kai Pan, Si-Yan Ren, Yi-Li Zhou","doi":"10.1097/COC.0000000000001109","DOIUrl":"https://doi.org/10.1097/COC.0000000000001109","url":null,"abstract":"BACKGROUND\u0000To construct a predictive model to direct the dissection of the central lymph nodes in papillary thyroid cancer (PTC) with BRAF V600E mutation by identifying the risk variables for central lymph node metastases (CLNM).\u0000\u0000\u0000METHODS\u0000Data from 466 PTC patients with BRAF V600E mutations underwent thyroid surgery was collected and analyzed retrospectively. For these patients, we conducted univariate and multivariate logistic regression analysis to find risk variables for CLNM. To construct a nomogram, the independent predictors were chosen. The calibration, discrimination, and clinical utility of the predictive model were assessed by training and validation data.\u0000\u0000\u0000RESULTS\u0000CLNM was present in 323/466 PTC patients with BRAF V600E mutations. By using univariate and multivariate logistic regression, we discovered that gender, age, tumor size, multifocality, and pathological subtype were all independent predictors of CLNM in PTC patients with BRAF V600E mutations. A predictive nomogram was created by combining these variables. In both training and validation groups, the nomogram demonstrated great calibration capacities. The training and validation groups' areas under the curve (AUC) were 0.772 (specificity 0.694, sensitivity 0.728, 95% CI: 0.7195-0.8247) and 0.731 (specificity 0.778, sensitivity 0.653, 95% CI: 0.6386-0.8232) respectively. According to the nomogram's decision curve analysis (DCA), the nomogram might be beneficial. As well, an online dynamic calculator was developed to make the application of this nomogram easier in the clinic.\u0000\u0000\u0000CONCLUSION\u0000An online nomogram model based on the 5 predictors included gender, age, pathological subtype, multifocality, and tumor size was confirmed to predict CLNM and guide the central lymph nodes dissection in PTC patients with BRAF V600E mutations.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fulfilling the Role of a Parent While Undergoing Treatment for Cancer: A Review of the Literature and the Potential Impact of Childcare Support on Cancer Outcomes.","authors":"Kang Woo Kim, M. Lopresti, Stephanie L. Graff, Sabrina Witherby, D. Dizon, M. Fenton","doi":"10.1097/COC.0000000000001102","DOIUrl":"https://doi.org/10.1097/COC.0000000000001102","url":null,"abstract":"Breast cancer is the most prevalent malignancy among adolescents and young adults (AYAs). Despite the efficacy of chemotherapy, AYA patients contend with psychosocial challenges, including psychological distress and financial toxicity, exacerbated further by those with dependent children. Parenting responsibilities intersect with cancer care, impacting both family dynamics and treatment adherence. Despite recognized needs, however, the impact of parenting concerns or even parenting status and the presence of dependents has not been systematically addressed and there is a paucity of interventional research regarding patients with cancer as concomitant caregivers. A feasibility study conducted by the Brown University Oncology Cooperative Group demonstrated the potential benefits of providing financial assistance for childcare, both improving treatment adherence and reducing distress among participants. Similar interventions have shown promise in addressing financial hardships for AYA patients with cancer who are concomitant caregivers. Ultimately, parenting concerns have a significant impact on medical decision-making, and further interventional research on childcare support is required to examine the ways in which health systems can improve family stability, stress, and quality of life.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140670962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Did We Get Here? The Progression From Frame-Based to Frameless Intracranial Stereotactic Radiosurgery.","authors":"Shearwood McClelland","doi":"10.1097/COC.0000000000001105","DOIUrl":"https://doi.org/10.1097/COC.0000000000001105","url":null,"abstract":"","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140668128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Images Based Brain Tumor Extraction, Segmentation and Detection Using Convolutional Neural Network and VGC 16 Model.","authors":"Ganesh Shunmugavel, K. Suriyan, Jayachandran Arumugam","doi":"10.1097/COC.0000000000001097","DOIUrl":"https://doi.org/10.1097/COC.0000000000001097","url":null,"abstract":"BACKGROUND\u0000In this paper, we look at how to design and build a system to find tumors using 2 Convolutional Neural Network (CNN) models. With the help of digital image processing and deep Learning, we can make a system that automatically diagnoses and finds different diseases and abnormalities. The tumor detection system may include image enhancement, segmentation, data enhancement, feature extraction, and classification. These options are set up so that the CNN model can give the best results.\u0000\u0000\u0000METHODS\u0000During the training phase, the learning rate is used to change the weights and bias. The learning rate also changes the weights. One Epoch is when all of the training images are shown to the model. As the training data may be very large, the data in each epoch are split into batches. Every epoch has a training session and a test session. After each epoch, the weights are changed based on how fast the CNN is learning. This is done with the help of optimization algorithms. The suggested technique uses the anticipated mean intersection over union value to identify failure instances in addition to forecasting the mean intersection over union.\u0000\u0000\u0000RESULTS\u0000This paper talks about how to separate brain tumors from magnetic resonance images of patients taken from \"Brain web.\" Using basic ideas of digital image processing, magnetic resonance images are used to extract and find tumors using a hybrid method. In this paper, the proposed algorithm is applied with the help of MATLAB. In medical image processing, brain tumor segmentation is an important task. The goal of this paper is to look at different ways to divide brain tumors using magnetic resonance imaging. Recently, automatic segmentation using deep learning methods has become popular because these methods get the best results and are better at solving this problem than others. Deep learning methods can also be used to process and evaluate large amounts of magnetic resonance imaging image data quickly and objectively.\u0000\u0000\u0000CONCLUSION\u0000A classification method based on a convolution neural network is also added to the proposed scheme to make it more accurate and cut down on the amount of time it takes to do the calculations. Also, the results of the classification are given as images of a tumor or a healthy brain. The training is 98.5% correct. In the same way, both the validation accuracy and validation loss are high.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Characteristics, Survival and Prognostic Factors in Gastrointestinal Large Cell Neuroendocrine Carcinoma: A Retrospective Cohort Study.","authors":"Lele Chang, Xuemei Zhang, Jiaxin Li, Qingwei Li","doi":"10.1097/COC.0000000000001104","DOIUrl":"https://doi.org/10.1097/COC.0000000000001104","url":null,"abstract":"BACKGROUND\u0000Gastrointestinal large cell neuroendocrine carcinoma (GILCNEC) has a low incidence but high malignancy and poor prognosis.The main purpose of this study was to thoroughly investigate its clinicopathological features, survival and prognostic factors.\u0000\u0000\u0000METHODS\u0000Information on patients with GILCNEC was extracted from the Surveillance, Epidemiology, and End Result program, and prognostic factors were analyzed by analyzing clinicopathological data and survival functions. Finally, multivariate analysis was applied to identify independent risk factors associated with survival.\u0000\u0000\u0000RESULTS\u0000A total of 531 individuals were screened in our study from the Surveillance, Epidemiology, and End Result database. The primary sites are mainly from the following: esophagus in 39 (7.3%) patients, stomach in 72 (13.6%) patients, hepatobiliary in 51 (9.6%) patients, pancreas in 97 (18.3%) patients, small intestines in 27 (5.1%), and colorectum in 245 (46.1%) patients. Esophagus, stomach, pancreas, and colorectum large cell neuroendocrine carcinoma (LCNEC) were more common in males (P = 0.001). Esophagus LCNEC had inferior overall survival (OS), whereas small intestine LCNEC was associated with better OS. The results of multivariate analysis showed that the American Joint Committee on Cancer Sixth Edition stage, surgery, and radiotherapy were independent prognostic indicators of OS in patients with GILCNEC (P < 0.05).\u0000\u0000\u0000CONCLUSIONS\u0000The prognosis of patients with GILCNEC varies depending on the primary tumor site. American Joint Committee on Cancer Sixth Edition stage, surgery, and radiotherapy are independent prognostic factors of patients with GILCNEC. Although surgery and radiotherapy can prolong the survival of patients with GILCNEC, their prognosis remains poor, and further prospectively designed multicenter clinical studies are needed to indicate the decision for clinicians.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Experience With Biologically Effective Dose-Comparable Short-Course Whole Brain Radiation Therapy for Metastatic Intracranial Disease.","authors":"Shearwood McClelland","doi":"10.1097/coc.0000000000001099","DOIUrl":"https://doi.org/10.1097/coc.0000000000001099","url":null,"abstract":"For inpatients with metastatic intracranial disease burden exceeding established guidelines for stereotactic radiosurgery (SRS), the standard of care involves whole brain radiation therapy (WBRT), typically administered as a 2-week course of treatment with biologically effective dose (BED) of 60 Gy. However, shorter course WBRT provides theoretical advantages in quality of life and decreasing systemic therapy delay. This retrospective study evaluates our early experience with BED-comparable short-course WBRT (23 Gy in 5 fractions; BED=58.3 Gy) for metastatic intracranial disease.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}